Advancing vocational education and training for persons with disabilities in Lao PDR: Empowering local initiatives to address a global imperative of inclusion for all

ObjectiveThis study aimed to determine the incidences of dengue-like illness (DLI), dengue virus (DENV) infection, and serotypes and to identify socio-demographical and entomological risk factors of DLI in selected suburban and rural communities in the Lao People's Democratic Republic and in Thailand.MethodsA two-year longitudinal study was conducted in four villages during the inter-epidemic period between 2011 and 2013. Entomological surveys, semi-structured interviews of household heads and observations were conducted. Occurrences of DLI were recorded weekly using the World Health Organization’s dengue definition along with blood samples; results were compared with national surveillance dengue data. Risk factors of DLI were assessed using logistic regression.ResultsAmong the 2007 people in the study, 83 DLI cases were reported: 69 in suburban Lao People's Democratic Republic, 11 in rural Thailand, three in rural Lao People's Democratic Republic and none in suburban Thailand. Four were confirmed DENV: two from suburban Lao People's Democratic Republic (both DENV-1) and two from rural Thailand (both DENV-2). Although the number of detected DLIs during the study period was low, DLI incidence was higher in the study compared to the dengue surveillance data in both countries. DLI in suburban Lao People's Democratic Republic was associated with age and occupation, but not with the number of pupae per person.DiscussionThis study highlights the importance of continuous clinical and vector surveillance for dengue to improve early detection of dengue and other mosquito-borne diseases in the region.

BackgroundAccurate information on the geographical distribution of malaria is important for efficient resource allocation. The Lao People's Democratic Republic has experienced a major decline in malaria morbidity and mortality in the past decade. However, efforts to respond effectively to these changes have been impeded by lack of detailed data on malaria distribution. In 2008, a countrywide survey on Plasmodium falciparum diagnosed in health centres and villages was initiated to develop a detailed P. falciparum risk map with the aim to identify priority areas for malaria control, estimate population at risk, and guide resource allocation in the Lao People's Democratic Republic.MethodsP. falciparum incidence data were collected from point-referenced villages and health centres for the period 2006-2008 during a country-wide survey between December 2008 and January 2009. Using the highest recorded annual rate, continuous surfaces of P. falciparum incidence were produced by the inverse distance weighted interpolation technique.ResultsIncidence rates were obtained from 3,876 villages and 685 health centres. The risk map shows that P. falciparum is highly heterogeneous in the northern and central regions of the country with large areas of no transmission. In the southern part, transmission is pervasive and the risk of P. falciparum is high. It was estimated that 3.4 million people (60% of the population) live at risk of malaria.ConclusionsThis paper presents the first comprehensive malaria risk map of the Lao People's Democratic Republic based entirely on empirical data. The estimated population at risk is substantially lower than previous estimates, reflecting the presence of vast areas with focal or no malaria transmission as identified in this study. These findings provide important guidance for malaria control interventions in the Lao People's Democratic Republic, and underline the need for detailed data on malaria to accurately predict risk in countries with heterogeneous transmission.

Paragonimiasis and its intermediate hosts in a transmission focus in Lao People's Democratic Republic

The Lao People's Democratic Republic is a multi-ethnic country. Therefore, during the process of revolutionary leadership, the Lao People's Revolutionary Party always considered ethnic issues and implementing ethnic policies as one of the important tasks in order to improve the material and spiritual life of ethnic minorities, consolidate and promote national unity bloc; striving to build the Lao People's Democratic Republic with economic development and political stability. To implement that policy, Laos has implemented many national guidelines and policies. The article focuses on clarifying the achievements and limitations in the implementation of ethnic policy in the Lao People's Democratic Republic. At the same time, exploit research results to serve the work of compiling documents and training according to Resolution 16/2018-ND/CP at the Vietnam Academy for Ethnic Minorities today. Keywords: Ethnic policy; Lao People's Democratic Republic; Ethnicity; Document compilation; Training program.

The purposes of this qualitative research were to investigate musical instruments, musical bands and lyrics of music among Hmong hill tribes in the northern region of the Lao People's Democratic Republic, to investigate the role of Hmong music in the northern region of the Lao People's Democratic Republic and to investigate musical preservation in the northern region of the Lao People's Democratic Republic. Results show that Hmong music in the Lao People's Democratic Republic has its own specific identity that has been handed down from generation to generation. The musical instruments contain their own identity and are produced from natural products. The instruments are believed harbor supernatural power. The musical instruments are divided into two categories: percussion and windpipes. Keng is the most important musical instrument for ritual ceremonies. Usually, Hmong musical bands are employed for ritual activities rather than recreation. Musical tunes are always played in continuous patterns for one round and repeated depending on the emotion of the musicians. The tone of musical tunes is comprised of short and long sounds. Musicians have their own freedom in creating different sounds in various musical tunes and their playing has no exact form. It depends on musicians to insert sounds or teach various playing techniques. As Hmong hill tribe people believe in spirits, their music plays an active role as a means to communicate with gods and the spirits of dead people. They believed that spirits are from the natural environment. So, Hmong hill tribe people believe that their music is a means to communicate with deceased people. This belief has made Hmong people adore their musical instruments and the musical instruments have never been changed. Musical instrument makers are native Hmong. Hmong music is still alive and active in various ritual activities as a means of preserving beliefs, culture and rites.

To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People's Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity. A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People's Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD. The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD. The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People's Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured.

IntroductionIn recent years, the incidence of measles has declined in the Lao People's Democratic Republic. However, an outbreak was reported in August 2014 in Houaphanh province, which was the biggest outbreak in the country since 2008. We describe the characteristics of this outbreak and outline critical interventions for the Lao People's Democratic Republic to achieve measles elimination.MethodsFever and rash cases in the Khouan and Samtai districts with an onset date from 1 September to 25 October 2014 were investigated. Active case finding and health facility record reviews were carried out. Appropriate samples from the individuals with suspected measles were tested to confirm the diagnosis.ResultsA total of 265 suspected cases including 12 deaths were reported from eight villages in the Khouan and Samtai districts. Forty-five individuals tested positive for measles IgM. Most of the confirmed patients were male (n = 28, 62%), less than 5 years old (n = 23, 51%) and from the Hmong ethnic community (n = 44, 98%). The majority of the people with suspected measles (n = 213, 80%) and all the confirmed ones were unvaccinated. A measles vaccination campaign conducted in the eight affected villages resulted in 76% coverage of the targeted population.DiscussionLow routine coverage and measles occurrence among unvaccinated individuals indicate underimmunized areas. The geographical and sociodemographic characteristics of this outbreak highlight the need for tailored vaccination strategies to close the immunity gap. A sensitive surveillance system that is able to detect, notify, investigate and guide response measures, including a second measles dose in the routine immunization schedule, will be essential for the Lao People's Democratic Republic to attain its measles elimination status.

Men who have sex with men are at high risk for HIV infection. Here we report the results of the first assessment of HIV prevalence and risk behaviour in this group in Vientiane, Lao People's Democratic Republic. Between August and September 2007, 540 men were enrolled from venues around Vientiane, using venue-day-time sampling. Men of Lao nationality, 15 years and over, reporting oral or anal sex with a man in the previous 6 months were eligible for participation. Demographic and socio-behavioural information was self-collected using hand-held computers. Oral fluid was tested for HIV infection. Logistic regression was used to evaluate risk factors for prevalent HIV infection. The median age of participants was 21 years; the HIV prevalence was 5.6%. Of participants, 39.6% reported exclusive attraction to men and 57.6% reported sex with women. Of those who reported having regular and nonregular sexual partner(s) in the past 3 months, consistent condom use with these partners was 14.4 and 24.2%, respectively. A total of 42.2% self-reported any sexually transmitted infection symptoms and 6.3% had previously been tested for HIV. Suicidal ideation was reported by 17.0%, which was the only variable significantly and independently associated with HIV infection in multivariate analysis. Although the HIV prevalence is low compared with neighbouring countries in the region, men who have sex with men in Lao People's Democratic Republic are at high behavioural risk for HIV infection. To prevent a larger HIV epidemic occurrence and transmission into the broader community, higher coverage of HIV prevention interventions is required.

Improving measles syndromic surveillance via dried blood spot testing in Laos 2016-17

In 2012 and 2013 participatory ethnobotany explorations were undertaken with herbalists from the Hmong ethnic group of Long Lan village, in Luang Prabang, Lao People’s Democratic Republic. These investigations into the knowledge and experience of indigenous elders of Long Lan and surrounding villages sought to identify the relationship between the spiritual-cultural practices and livelihood uses of plants and their conservation. Information about 74 plant species of 49 families was recorded, including 25 herbs (17 perennial, 8 annual), 20 trees, 17 shrubs, 10 climbers, and 2 ferns. Analysis of quantitative ethnobotany scores indicated positive trends between uses and conservation practices for plants. The study suggests that the traditional Hmong cultural uses for plants may be a mechanism for the conservation of biodiversity in the rapidly deteriorating forests of Luang Prabang in the Lao People’s Democratic Republic. Tshawb nrhiav nroj tsuag tau muaj kev koom tes nrog cov kws tshuaj ntsuab Hmoob nyob rau zos Long Lan, Xeev Luang prabang, Los Tsuas Teb chaws tau pib tshawb los rau ntawm lub xyoo 2012 thiab 2013. Nrhiav txog lub laj lim thiab tswv yim ntawm cov laus neeg nyob zos Long Lan thiab cov zos nyob ib puag ncig twb yog ib qhov sij hawm muaj txiaj ntsig tau paub txog txoj kev cai coj siv nroj tsuag thiab pov hwm nyob nrog lub neej. Tau paub txog ntawm 74 hom tau muaj 49 yam (nroj tsuag) twb tau muab sau zoo, qhov nov muaj 25 yam tshuaj ntsuab (17 yam yog cov muaj hnub nyooj ntev thiab 8 yam yog cov muaj hnub nyooj luv), 20 yam yog cov ua ntoo, 17 yam yog cov nroj, 10 yam yog cov hmab, thiab 2 yam yog suab. Muab xam tau pom txog nroj tsuag muaj txiaj ntsig zoo heev rau ntawm txoj kev siv yoom thiab pov hwm nyob nrog lub neej. Qhov tshawb rhiav no tau ceeb toom txog tias txoj kev siv yoom nroj tsuag raws li txoj cai Hmoob coj yog ib txoj cai zoo rau ntawm kev pov hwm hav zoov hav tsuag rau qhov hav zoov niaj hnub no raug luaj ntov nyob rau xeev Luang prabang, los Tsuas Teb.

Exchange of letters constituting an agreement between the United Nations and the Government of the Lao People's Democratic Republic concerning arrangements for the Regional Workshop for South-East Asian Countries on the Methodological Review of Benchmarking, Rebasing and Chain-linking of Economic Indicators to be held in Vientiane, Lao People's Democratic Republic from 24 to 26 August 2011. New York, 6 July 2011 and 29 July 2011

ObjectiveTo assess the antibiotic prescribing practices of doctors working in the Lao People's Democratic Republic and their knowledge of local antibiotic resistance patterns.MethodsDoctors attending morning meetings in 25 public hospitals in four provinces were asked to complete a knowledge, attitude and practice survey. The questionnaire contained 43 multiple choice questions that the doctor answered at the time of the meeting.FindingsThe response rate was 83.4% (386/463). Two hundred and seventy doctors (59.8%) declared that they had insufficient information about antibiotics. Only 14.0% (54/386) recognized the possibility of cephalosporin cross-resistance in methicillin-resistant Staphylococcus aureus. Most participants had no information about local antibiotic resistance for Salmonella Typhi (211/385, 54.8%) and hospital-acquired pneumonia (253/384, 65.9%). Unnecessary antibiotic prescriptions were considered as harmless by 115 participants and 148 considered locally-available generic antibiotics to be of poor quality. Nearly three-quarters (280/386) of participants agreed that it was difficult to select the correct antibiotics. Most participants (373/386) welcomed educational programmes on antibiotic prescribing and 65.0% (249/383) preferred local over international antibiotic guidelines.ConclusionDoctors in the Lao People's Democratic Republic seem to favour antibiotic prescribing interventions. Health authorities should consider a capacity building programme that incorporates antibiotic prescribing and hospital infection control.

BackgroundThis study examines the potential of aid effectiveness to positively influence human resources for health in developing countries, based on research carried out in the Lao People's Democratic Republic (Lao PDR). Efforts to make aid more effective – as articulated in the 2005 Paris Declaration and recently reiterated in the 2008 Accra Agenda for Action – are becoming an increasingly prominent part of the development agenda. A common criticism, though, is that these discussions have limited impact at sector level. Human resources for health are characterized by a rich and complex network of interactions and influences – both across government and the donor community. This complexity provides a good prism through which to assess the potential of the aid effectiveness agenda to support health development and, conversely, possibilities to extend the impact of aid-effectiveness approaches to sector level.MethodsThe research adopted a case study approach using mixed research methods. It draws on a quantitative analysis of human resources for health in the Lao People's Democratic Republic, supplementing this with a documentary and policy analysis. Qualitative methods, including key informant interviews and observation, were also used.ResultsThe research revealed a number pathways through which aid effectiveness is promoting an integrated, holistic response to a range of human resources for health challenges, and has identified further opportunities for stronger linkages. The pathways include: (1) efforts to improve governance and accountability, which are often central to the aid effectiveness agenda, and can be used as an entry point for reforming workforce planning and regulation; (2) financial management reforms, typically linked to provision of budget support, that open the way for greater transparency and better management of health monies and, ultimately, higher salaries and revenues for health facilities; (3) commitments to harmonization that can be used to improve coherence of donor support in areas such as salary supplementation, training and health information management.ConclusionIf these opportunities are to be fully exploited, a number of constraints will need to be overcome: limited awareness of the aid effectiveness agenda beyond a core group in government; a perception that this is a donor-led agenda; and different views among partners as to the optimal pace of aid management reforms. In conclusion, we recommend strategic engagement of health stakeholders in the aid effectiveness agenda as one means of strengthening the health workforce.

Hematophagous parasites such as leeches, ticks, mites, lice, bedbugs, mosquitoes, and myiasis-producing fly larvae are common health problems in Lao People's Democratic Republic. Several arthropod-borne infections, e.g., malaria, dengue fever, and Japanese encephalitis, are endemic there. Effective vector control methods including the use of pesticides, insecticide-treated bed nets, and synthetic and plant-based repellents are important means of control against such invertebrates and the pathogens they may transmit or directly cause. In this study, we documented traditional knowledge on plants that are used to repel or kill hematophagous arthropods, including mosquitoes, bedbugs, human lice, mites and ticks, fly larvae, and blood-sucking leeches. Structured interviews were carried out in 66 villages comprising 17 ethnic groups, covering a range of cultures, throughout Lao People's Democratic Republic. A total of 92 plant species was recorded as traditional repellents (including plants for pesticidal usages) in 123 different plant-ectoparasite combinations. The number and species of plants, and animal taxa repelled (or killed) per plant species differed per region, village, and ethnic group. Traditional use was confirmed in the scientific literature for 74 of these plant species, and for an additional 13 species using literature on closely related species. The use of botanical repellents and pesticides from many plant species is common and widespread in the Lao countryside. In the future, the identification of the active components in certain plants to develop more optimal, inexpensive repellents, insecticides, acaricides, or antileech compounds as alternatives to synthetic repellents/pesticides against blood-feeding insects, ticks, mites, and leeches is warranted.

Technological advances and accessibility influence the utilization of health services in today's world, but barriers still exist. This study aims to comprehensively analyze the utilization of maternal health services and the barriers that hinder access in the Lao People's Democratic Republic (PDR). This study analyzed 2023 MICS data from 3,754 women in the Lao People's Democratic Republic, examining maternal health service utilization. The dependent variable was categorized as utilization or non-utilization, while the independent variables included demographics, geography, decision-making power, and health system factors. Descriptive statistics, chi-square tests, and binary logistic regression were used for data analysis. This study found that of the 3,754 respondents, 2,930 people used health services to give birth. The chi-square test showed that age, education, residence, region, decision making, insurance ownership, and wealth index were significantly associated with using maternal health services. Multivariate analysis showed that higher education was the strongest predictor of health service use (OR = 20.90), with geographic factors, wealth inequality, and shared decision-making. Areas without road access and the poorest wealth groups were less likely to use services, while shared decision-making increased the likelihood by 45%. It is recommended that higher education be promoted, road access improved, and shared decision-making be encouraged to increase the utilization of maternal health services, especially among the poorest communities and those living in rural areas.